Demographic implications of health care in Sri Lanka
Abeykoon, A.T.
Asia-Pacific Population Journal 11(2): 47-58
1996
ISSN/ISBN: 0259-238X PMID: 12347641 Document Number: 304879
This article describes changes in population size, structure, and growth in Sri Lanka. The population aged under 15 years was 37% of total population in 1946, peaked at almost 42% in 1963, and declined to 31% in 1991. The age structure is the result of population growth patterns during 1946-91. The peak in 1963 and high rates of growth were due to improved mortality, effective application of DDT in malaria areas, improved health care, improved agricultural production, subsidized distribution of food, and expanded free education. The population growth rate declined primarily due to a decline in fertility. During 1980-93 the total fertility rate declined at an average annual rate of 4.0%. Fertility decline was strongly influenced by increased age at marriage and contraceptive prevalence. The mean age at marriage increased from 20.7 years in 1946 to 25.5 years in 1993. The contraceptive prevalence rate increased from 32.0% in 1975 to 66.1% in 1993. Fertility decline was initially influenced strongly by changes in nuptiality. After the early 1970s, fertility decline was primarily due to declines in marital fertility. During 1972-82, 75% of fertility decline was accounted for by contraceptive use. Given the present trends in fertility, mortality, and international migration, it is expected that Sri Lanka will increase in population size from 18.2 million in 1995 to 22.4 million in 2020. Stabilization of population is likely to occur around 24 million by 2050. Population size at stabilization would be 33% greater than present levels. Population age structure will continue to change. By 2030, the aging process will accelerate, and the working-age proportion will expand. The demands of this expanded population will be on health care services, employment, housing, and food. The demands on health care would be the greatest among persons aged 45-49 years.